I have had lomi lomi massage and it is wonderful. I don't see how you could do that with your underwear on with all the oil and underneath longer strokes. I have always been unclothed but draped. I like the longer strokes and I have fibromyalgia as well as a pelvic pain condition. For this reason, abdominal massage is really good for me. Over time, some of my therapists when we became comfortable with one another have offered more minimal draping and I have gladly taken it. I do not get nervous - that is one of the problems with fibromyalgia in that I am too tired and in pain to even care about anything.